Provider Demographics
NPI:1831357037
Name:CHATTER BUG LLC
Entity type:Organization
Organization Name:CHATTER BUG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:POTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-589-2553
Mailing Address - Street 1:906 CONFIDENCE DR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-8495
Mailing Address - Country:US
Mailing Address - Phone:303-589-2553
Mailing Address - Fax:
Practice Address - Street 1:906 CONFIDENCE DR
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80504-8495
Practice Address - Country:US
Practice Address - Phone:303-589-2553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-26
Last Update Date:2008-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO26781760Medicaid